SLHS 457 Exam 1

What is Evidence-Based Practice?

A framework of care that emphasizes integration of client perspective, clinical expertise, and evidence (both internal and external)

What is external evidence?

What is known about similar cases, empirical evidence, theories and general knowledge, clinician preferences and worldview.

What is internal evidence?

Related to the specific case, including clinical information about the client, client values and preferences, and contextual factors.

What are client values and preferences?

What clients are looking for, their concerns, what they want or do not want, and their personality type.

What are contextual factors in evidence based practice?

Factors particular to the client and situation, such as insurance, time/duration of assessment, and clinician qualifications.

What is empirical evidence?

Research or scientific evidence.

What is clinical evidence?

Internal evidence gathered through clinical experience and client assessment data.

What is clinical knowledge?

What you know about things (general knowledge), not expertise.

What is clinical expertise?

Develops through clinical experience and theoretical understandings of communication development and disorders.

What is a referral?

How the client comes to you, often from a family member, physician, or other professionals.

What is intake?

The process of writing down referral information before any assessment.

What is screening?

The process to determine if someone needs further assessment.

What is test sensitivity?

The ability of a test to identify individuals who would benefit from more assessment.

What is test specificity?

The ability of a test to avoid overidentifying individuals who do not need assessment.

Why is it important for a test to be both sensitive and specific?

To ensure that those who need services are identified without overidentifying others.

What items are typically found in a pediatric client file?

IEP, case/medical history, past assessments, birth information, hearing test, grades, referral.

What items are typically found in an adult client file?

Case/medical history, hearing test, occupational history, self-assessment/questionnaire.

Who can make a referral?

Family members, physicians, school districts, medical SLPs, teachers, psychologists, etc.

What is the purpose of screening before conducting a full assessment?

To determine if a child needs an assessment and to plan for that assessment.

What are standardized measures?

Tests that are always administered the same way, ensuring reliability and validity.

What is baseline level of functioning?

The client's current communicative behavior, including strengths and challenges prior to intervention.

What are clinician-derived assessment measures?

Not standardized but may be informally compared to a standard or criterion. Includes behavioral observations and interviews.

What is reliability in testing?

The test yields the same results when administered multiple times to the same individual.

What is inter-rater reliability?

Same results when given by different people.

What is intra-rater reliability?

Same results when given by the same person each time.

What is a norming sample?

The sample to which a client’s score is compared to, that represents a certain population.

What is a standard score?

Helps determine how close or far from the average a client may be.

What is percentile rank?

Indicates the percentage of individuals from the normative sample who perform at or below a given standard score.

What is a confidence interval?

A range of scores within which the client's true score is likely to fall.

What is standard deviation from the mean?

How far from the mean an average individual's performance may be.

What is an oral mechanism examination?

An assessment of the oral structures and functions.

What is dynamic assessment?

Assessment which allows for cueing/prompting to determine how a client performs with certain supports.

What is the zone of proximal development?

The space between what a client can do on their own and what they can do with assistance.

What are the three purposes of assessment?

To identify the presence of a disorder, design treatment, and monitor progress over time.

Why is it important to write clinical assessment questions?

It helps build a framework of what needs to be analyzed further.

Why is it important to plan your assessment to be both comprehensive and efficient?

Comprehensive evaluations provide full insight, while efficient assessments allow for seeing more clients.

What is the difference between norm-referenced measures and criterion-referenced measures?

Norm-referenced compares one person to a population; criterion-referenced compares one person to a criteria.

When is a person's skills considered delayed on the normative bell curve?

-1.5 SD below the mean and 7.5% percentile rank.

What are the benefits/risks of reporting a 90% versus a 95% confidence interval?

Higher confidence requires wider intervals, making interpretation harder.

What is the confidence level for a test with high reliability?

95%

What is the confidence level for a test with low reliability?

90%

What do interviews and portfolio reviews help clinicians do?

Interpret information, ask questions, and develop criteria for evaluation.

What are you looking for in an oral mechanism exam?

Anatomy differences.

How is the theory of the zone of proximal development utilized during dynamic assessment?

Dynamic assessment examines what the client is capable of with supports, and what level of supports is required. You want to make the assessment tasks difficult enough that the child cannot master them without help so you can evaluate how they responds to supports. Thus, the zone of proximal development is used as it is the “sweet spot” where a child needs assistance but can perform the tasks with help.

What is communication?

A message being sent or received between at least two people.

What is language?

A rule-based, symbolic, shared code.

What is speech?

Any sound made from the oral mechanism.

What is syntax?

Rules that govern the internal structure of language, including grammar and word order.

What is morphology?

Construction of words; meaning can change based on chunking.

What is phonology?

Rules of how sounds can be combined into words.

What is pragmatics?

Meaning of words in context.

What is semantics?

Rules for how we combine units into sounds/sentences.

What is a speech sound disorder?

Any impairment in the production, perception, motor movements, and planning of speech.

What is intelligibility?

How well a client's speech can be understood.

What is aphasia?

A loss or change in language functioning due to neurological conditions.

What is agraphia?

An acquired writing disorder due to brain injury.

What is alexia?

An acquired reading disorder due to brain injury.

What is apraxia?

A neurological speech disorder affecting planning of movements for speech.

What are phonological processes?

Patterns of speech sound errors produced during childhood.

What is phonemic inventory?

A speech sample to determine which consonants and vowels a child produces.

What are the three language domains?

Language Content: Semantics; Language Use: Pragmatics; Language Form: Phonology, Morphology, Syntax.

What does ethnicity refer to?

Personal identity with reference to a group of common descent.

What is a dialect?

A rule-governed variety of a language characterized by social, ethnic, and geographical differences.

What is culture?

Socially transmitted behavior patterns, arts, beliefs, and institutions.

What is content bias?

When test methods reflect assumptions that all children have similar experiences.

What is linguistic bias?

Disparity between the language used by the examiner and the child.

What is disproportionate representation in normative samples?

Standardized tests historically not including CLD populations.

What are processing-dependent measures?

Measures minimally dependent on prior knowledge or experience.

What are criterion-referenced measures?

Measures that compare client’s score to a predetermined set of criteria (do they meet the criteria for their age?)

What does CLD stand for?

Cultural and Linguistic Diversity.

Why are criterion-referenced measures preferable for CLD children?

They do not compare responses against norms that may not apply.

What is wrong with the term 'Standard American English'?

It ignores the existence of multiple dialects.

How many people in the US speak languages other than English?

57.1 million.

Is simultaneous vs sequential bilingual learning a false dichotomy?

Yes, bilingualism should be viewed as a continuum.

What is the difference between dialect and accent?

Dialect refers to all aspects of language; accent refers only to pronunciation.

What is differential diagnosis?

Weighing one diagnosis against another.

What is ableism?

Discrimination in favor of nondisabled people.

What is dosage in therapy?

Frequency and duration of therapy sessions.

What is prognosis?

Looking into the future regarding a client's trajectory.

What does eligibility refer to in assessment?

Determining if a client is eligible for services.

What can a practitioner do to be anti-ableist?

Treat every client equally and advocate for them.

What is the difference between disorder, delay, and impairment?

Delays are often temporary; disorders are long-term; impairments can be functional limitations.

Ethnographic Assessment

A client is observed in several contexts with multiple conversational partners. Family members can be asked about their own culture, their attitudes about the host culture, communication in the home, and how the client’s communication compares to that of the community. Clients’ communicative abilities are observed and described during genuine communication in a naturalistic environment.

Test-teach-restest measures

Dynamic assessment in between the zone of proximal development, assessing their ability to learn

Processing-dependent measure

Measures that place more emphasis on processing abilities and less emphasis on prior language knowledge and experience (memory tasks, perceptual tasks, stimuli tasks)

Phonological process

Weak syllable deletions, deaffrication, fronting, final consonant deletion, gliding, stopping, cluster reduction